Service Reports are prepared by EIA upon special request and may be based on assumptions specified by the requestor. Information regarding the request for this report is included in the Preface. Preface This study was undertaken at the request of the General Accounting Office (GAO). Its purpose is to evaluate the impacts on U.S. energy markets and the economy of reducing oil imports. The approach and assumptions underlying this report were specified by GAO and are attached as an Appendix. The study focuses on two approaches: (1) a set of cases with alternative world crude oil price trajectories and (2) two cases which investigate the use of an oil import tariff to achieve a target reduction in the oil imports. The analysis presented uses the National Energy Modeling System, which is maintained by the Office of Integrated Analysis and Forecasting within the Energy Information Administration (EIA), and the DRI/McGraw Hill Macroeconomic Model of the U.S. Economy, a proprietary model maintained by DRI and subscribed to by EIA. The National Energy Modeling System (NEMS) is an integrated energy-economy modeling system for U.S. energy markets, developed by the EIA as a policy analysis tool to provide an integrated framework for policymakers to understand the implications of proposed policies and alternative assumptions concerning energy markets. NEMS is used annually by EIA's Office of Integrated Analysis and Forecasting (OIAF) to produce a Reference Case and a range of alternative projections for the midterm future, which are published in the Annual Energy Outlook. projects energy trends to the year 2015. While the future entails many uncertainties, the AEO96 Reference Case reflects EIA's assessment of the most likely direction of U.S. energy indicators. The Reference Case assumes that current laws and regulatory policies will continue into the future.

The General Accounting Office

Beyond Academics: A Holistic Framework for Enhancing Education and Workplace Success. ACT Research Report Series. 2015 (4).

Purpose
Reduced access to care and barriers have been shown in rural populations and in publicly insured populations. Barriers limiting health care access in publicly insured populations living in rural areas are not understood. This study investigates rural-urban differences in system-, provider-, and individual-level barriers and access to preventive care among adults and children enrolled in a public insurance program in Minnesota.

Methods
This was a secondary analysis of a 2008 statewide, cross-sectional survey of publicly insured adults and children (n = 4,388) investigating barriers associated with low utilization of preventive care. Sampling was stratified with oversampling of racial/ethnic minorities.

Results
Rural enrollees were more likely to report no past year preventive care compared to urban enrollees. However, this difference was no longer statistically significant after controlling for demographic and socioeconomic factors (OR: 1.37, 95% CI: 1.00-1.88). Provider- and system-level barriers associated with low use of preventive care among rural enrollees included discrimination based on public insurance status (OR: 2.26, 95% CI: 1.34-2.38), cost of care concerns (OR: 1.72, 95% CI: 1.03-2.89) and uncertainty about care being covered by insurance (OR: 1.70, 95% CI: 1.01-2.85). These and additional provider-level barriers were also identified among urban enrollees.

Conclusions
Discrimination, cost of care, and uncertainty about insurance coverage inhibit access in both the rural and urban samples. These barriers are worthy targets of interventions for publicly insured populations regardless of residence. Future studies should investigate additional factors associated with access disparities based on rural-urban residence.

/pdf/rural-urban-differences-in-access-to-preventive-health-care-1ygnllfaar.pdf

Rural-Urban Differences in Access to Preventive Health Care Among Publicly Insured Minnesotans

This article examines the impact of the Internet on the provision of career information and describes the development of a career and educational information web site. Three models for linking career assessment to career information are evaluated: Print-based, Computer-Assisted Career Guidance systems, and Internet-based. The design of Career Exploration Links is described in detail as a case study in organizing career and educational information on the Internet and guiding a diverse college student population toward accessing this information in meaningful ways. This case demonstrates a number of advantages that underlie the Internet-based model as a vehicle for linking career assessment with career information.

Mining the Internet for Career Information: A Model Approach for College Students:

This study extends previous research by examining perceived closeness as a moderator of traditional relationship measures such as satisfaction, trust, commitment, and psychological comfort, and the impact of each on the intention of the patient to remain with his/her physician. Our findings reveal that in cases where the patient feels close to the physician, psychological comfort with the physician is the most important factor in predicting patient retention. For those who feel less close to the physician, satisfaction is theprimary predictor of patient retention. Therefore, as a close relationship develops between the patient and doctor, the patient's comfort level becomes increasingly important as an exit barrier, even outweighing patient satisfaction.

The impact of perceived closeness on the differing roles of satisfaction, trust, commitment, and comfort on intention to remain with a physician.

University students and career decidedness: effects of two computer-based career guidance interventions

Objectives: The objective of this study was to understand how the dynamics of the health care provider-patient relationship differ between Medicaid patients and private pay patients in the context of obstetric care. Various aspects of the patient-physician relationship were examined including trust, commitment, dependence, social content, service quality, and behavioral outcomes such as satisfaction, referral behavior, ease of voice, and retention. Methods: Questionnaires were mailed to a sample of mothers who had recently given birth. MANOVA was used to compare the means of Medicaid patients with private pay patients for the variables of interest in the study. Results: Medicaid patients had lower commitment to their primary physician. They trusted the practice, the primary physician, and the other physicians in the practice less. They perceived themselves as less similar to both the overall practice and their primary physician and also rated their health care service experience lower. They were ...

Assessing Medicaid patients' perceptions of the OB/GYN-patient relationship.

Allopathic medicine faces a daunting challenge of selecting the best applicants because of the very high applicant / matriculant ratio. The quality of graduates ultimately reflects the quality of medical practice. Alarming recent trends in physician burnout, misconduct and suicide raise questions of whether we are selecting the right candidates. The United States (US) lags far behind the United Kingdom (UK) and Europe in the study of non-cognitive tests in medical school admissions. Although more recently, medical schools in both the UK, Europe and the US have begun to use situational judgement tests such as the Computer-Based Assessment for Sampling Personal Characteristics (CASPer) and the situational judgement test (SJT), recently developed by the Association of American Medical Colleges (AAMC) and that these tests are, in a sense non-cognitive in nature, direct personality tests per se have not been utilized. We have historically used, in the admissions process within the US, knowledge, reasoning and exam performance, all of which are largely influenced by intelligence and also improved with practice. Personality, though also undoubtedly influenced by intelligence, is fundamentally different and subject to different kinds of measurements.A popular personality measurement used over the past two decades within the US in business and industry, but not medical school has been the Neo Personality Inventory - Revised (NEO-PI-R) Test. This test has not been utilized regularly in allopathic medicine probably because of the paucity of exploratory retrospective and validating prospective studies. The hypothesis which we tested was whether NEO-PI-R traits exhibited consistency between two institutions and whether their measurements showed probative value in predicting academic performance.Our retrospective findings indicated both interinstitutional consistencies and both positive and negative predictive values for certain traits whose correlative strengths exceeded traditional premed metrics: medical college admission test (MCAT) scores, grade point average (GPA), etc. for early academic performance.Our exploratory studies should catalyze larger and more detailed confirmatory studies designed to validate the importance of personality traits not only in predicting early medical school performance but also later performance in one's overall medical career. 

https://bmcmededuc.biomedcentral.com/counter/pdf/10.1186/s12909-022-03901-x

A. Peter Eveland

Papers

University students and career decidedness: effects of two computer-based career guidance interventions

Assessing Medicaid patients' perceptions of the OB/GYN-patient relationship.

A preliminary study of the probitive value of personality assessment in medical school admissions within the United States